COVID-19 Pandemic Impacts on Children with Developmental Disabilities: Service Disruption, Transition to Telehealth, and Child Wellbeing

Abstract

The COVID-19 pandemic has resulted in substantial service disruption and transition from in-person services to telehealth for children with developmental disabilities. However, there is limited knowledge about the specific dimensions and consequences of the disruption and transition. This study aims to examine the extent of service disruption and transition, the experiences of client children and their caregivers with telehealth vis-à-vis in-person services, and the impacts of the disruption and transition on child wellbeing. The cross-sectional study collected data from parents of children with developmental disabilities using an online survey. McNemar’s tests were used to compare service changes before and after the pandemic outbreak, and multivariate analyses were used to examine how service changes were associated with child wellbeing. Results show that more than two-thirds of the children experienced reduction in service amount, and one-third lost services for more than two months in about five months into the pandemic. While telehealth had comparable features relative to in-person services, it had lower ratings with respect to diagnostic accuracy, treatment effectiveness, and rapport building. Service disruption/transition and social isolation were associated with behavioral and emotional deterioration in children. However, child and family stress may have confounded these adverse effects. We concluded that the magnitude of service disruption and transition was large in the first half year after the pandemic outbreak, and the amount and duration of service loss varied substantially across clients. Diagnostic accuracy, treatment efficacy, and rapport building were areas in which parents had major concerns toward telehealth relative to in-person services. However, such drawbacks may partially be due to the limited logistics in telehealth implementation during the pandemic. Service disruption and transition seemed to contribute to family stress, which played a direct role in eroding child wellbeing. Implications of these findings for future research and practices are discussed.

Health and Education Services During the COVID-19 Pandemic Among Young Children with Autism Spectrum Disorder and Other Developmental Disabilities

“…Hence, while telehealth can reduce disparities in access by bridging geographic distances to care and increasing flexibility, it can also widen disparities for families without efforts to ensure access to technological resources. 15,27,29,30 There are limitations to this study. While we observed that difficulty using telehealth was a common reason for missed or delayed appointments, we were not able to determine the extent to which these difficulties were related to limitations in family resources, child characteristics and behavioral skills, or other factors.…”

“…Hence, while telehealth can reduce disparities in access by bridging geographic distances to care and increasing flexibility, it can also widen disparities for families without efforts to ensure access to technological resources. 15,27,29,30…”

“…5–8 Numerous studies have suggested impacts were more pronounced for children with ASD and other developmental disabilities, 5,9 with at least some disruption reported by 65%–88% of caregivers and many children experiencing a complete loss of services. 10–16 The more extreme impact on service access and delivery for children with ASD may be related to their need for comprehensive services to address developmental and co-occurring medical conditions, 2–4 reliance on specialty services in both clinic settings and school-based programs, 2,17,18 and potential difficulties using telehealth and remote learning services. 9,12,14–16 Developing strategies to promote continuity of services during future public health emergencies will require a better understanding of the types of services most affected and the factors associated with disruptions for children with ASD and other developmental disabilities.…”

Alignment of Canada's COVID-19 policy response with barriers and facilitators for coping reported by caregivers of youth with developmental delays, disorders, and disabilities

“…While many governments successfully slowed the spread of COVID-19 through the adoption of these regulations, scholarly findings indicate that children and youth with disabilities experienced negative impacts on their wellbeing along with limited or reduced access to services and supports ( 3 , 4 ). Compelling evidence suggests that pre-existing vulnerabilities and inequities for many children and youth with developmental disabilities and disorders (DDDs) were amplified by the pandemic ( 5 , 6 ).…”

Telehealth services for children with neuro‐developmental disabilities in the Asia‐Pacific region: A systematic review

“…Exchanging information related to healthcare using telecommunication as a modality was practised over many years. Synchronous, asynchronous and hybrid modes were used to obtain health related information and deliver necessary services through audio or video consultations (Zhang et al, 2022). Telehealth is an evolving and an expanding service enabler practised predominantly in high‐income countries (HICs) and specifically in adult medicine (Doraiswamy et al, 2021).…”